| NPI | 1962968388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24642) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043418-1) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2020-05-12 |